One question that has come up repeatedly over the years when I have been working with leaders that are new to the idea of culture change is, “Where do I start?”  

The question seems so simple, yet the task of changing the long-standing institutional culture that exists can seem daunting even for the strongest of leaders.  My response to the question comes in the form of a question; “What are we trying to create?” The learner quickly responds by saying, “We are trying to create a home for the elder.”

If we draw a diagram of a house and then ask, “What is the most important part of a house; or what part of the house should I build first?” I will always hear a quick response of “the foundation!” This builds the framework to discuss the importance of personal transformation and the idea of opening our hearts and minds to a new way of creating home for the elders. 

Personal transformation is the foundation of culture change. In the diagram of the house, the walls represent the way we change our systems and how we do the work. The roof represents the physical changes that might take place as a result of the personal transformation already being done. These things might be adding a café or a chapel to a home.  In my experience, the organizations that focus on physical or operational changes first rather than committing to the hard work of personal transformation and relationship building, will struggle when it comes to creating a lasting culture.

In order to create home, we start with the foundation of changing ourselves and strengthening our relationships with those around us. To do that, I encourage leaders to focus on three things:

  • Language
  • Becoming well-known
  • Communication. 

We all know that simple words such as “patient”, “facility”, or “wanderer” can create perceptions that greatly affect the culture around us. Leaders have to be the first to model the new way of seeing the world by using empowering words like “elder,” “home,” or “a person who wanders.”

Becoming well-known to one another is as simple as getting to know the people who live and work in the home. This is much deeper than knowing someone’s name. It also is knowing and honoring who and what is important to them. It is important to make it a practice to learn these things as they move into the home or join the organization. Naturally then you can use what you have learned in your daily conversations and interactions.  It is hard to invest in a relationship if you don’t truly know each other.  

Finally, creating time and space for communication is vital to creating home. The Learning Circle is a phenomenal tool that provides an avenue for everyone, Elders and employees alike, to speak freely and share their ideas on a given topic, whereas quick team huddles during shifts can help team members relay needed information to each other. Leaders who model these communication practices with their leadership team have greater success in creating a culture built on the foundation of relationships.

When faced with the question of where to start on the culture change journey; remember to start with the three things that will matter most and have the biggest impact on building a firm foundation.

Ryan Myracle, LAPSW, LNHA, is the Hometown Culture Change Learning Manager at Signature HealthCARE.